Do you suffer from COPD (Chronic Obstructive Pulmonary Disease), a long-term lung disease that makes it hard to breathe and feels like your chest is constricted? If so, your doctor may have given you a special inhaler that you use with a purple capsule. Its name is Tiotropium, but most people know it by the brand name Spiriva HandiHaler. So, today we will talk very simply about how to use this medicine exactly, what things to be careful about, and what side effects may occur.
First of all, what is this medicine called Tiotropium?
Simply put, Tiotropium is a medicine that widens the airways in your lungs and makes it easier to breathe. This is very important because it is not a 'reliever' inhaler that you use in an emergency, that is, when you suddenly have difficulty breathing. It is a 'controller' inhaler . This means that you use it every day, as prescribed by your doctor, to control your symptoms. This helps you to control your breathing throughout the day and stay comfortable.
Things you should tell your doctor before taking this medicine
Before your doctor prescribes this medication, he or she will need to know your complete health history. Be sure to tell them about any of the following conditions, especially:
- Glaucoma: If you have glaucoma, a condition in which pressure in the eye increases. This medicine can sometimes affect eye pressure.
- Kidney disease: If you have any impairment in the functioning of your kidneys.
- Prostate disease: If you are a man, if you have problems such as an enlarged prostate, this medicine may cause difficulty urinating.
- Allergies: You must tell us if you have any allergies to this medicine (Tiotropium), to Ipratropium, to Atropine, to lactose in milk, or to any other medicine, food, or dye.
- Pregnancy or breastfeeding: If you are pregnant, trying to get pregnant, or breastfeeding, you should talk to your doctor about this.
Very important! How to use this inhaler correctly?
This is the most important part. To get the most out of this medicine, you need to use it correctly.
Very important: Never swallow the capsule that comes with this medicine with water! It is not meant to be swallowed, but to be placed in an inhaler and the medicine powder inside is inhaled.
When you are given the medicine, you will receive a leaflet that tells you how to use it. Read it carefully. Usually, what you need to do is:
1. Open the top of the inhaler.
2. Place the capsule in the designated area.
3. Close the mouthpiece of the inhaler and press the green button on the side once. This will puncture the capsule and release the medicine powder.
4. Exhale deeply, place the mouthpiece of the inhaler in your mouth, close your lips tightly, and take a quick, deep breath in. You will feel the medicine go into your lungs.
5. Hold your breath for about 10 seconds, then slowly exhale.
6. Check to see if there is any medicine left in the capsule, and inhale again if necessary.
7. Remove the used empty capsule and close the inhaler.
Get into the habit of taking this at the same time every day. That way you won't forget. Don't stop taking the medicine until your doctor tells you to.
What to do if you miss a dose of medication?
If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Never take a double dose.
What if I take too much medicine?
If you think you have accidentally taken too much medicine, immediately call the National Poisons Information Centre at the Colombo National Hospital , or go to the ETU (Emergency Treatment Unit) of the nearest hospital.
Things to consider when using Tiotropium
- This is not for emergencies: As we mentioned earlier, this is not helpful if your breathing suddenly becomes difficult. Your doctor may have given you a special 'Reliever' inhaler (like the blue Ventolin) to use in such cases. Use that. If you need to use that Reliever inhaler more often, it means that your condition is not under control. See your doctor immediately.
- Dry mouth: This medication may cause dry mouth. Chewing sugar-free gum, sucking on sugar-free candy, and drinking plenty of water throughout the day can help. If this problem persists, tell your doctor .
- Drowsiness and dizziness: Some people may feel a little drowsy or dizzy. So, stay away from dangerous activities like driving or operating machinery until you know how this medicine affects you. Especially if you are an elderly person, stand up slowly when you get up from a sitting position or bed. Otherwise, you may feel dizzy and fall.
Are we also aware of the side effects?
Like any medicine, this one can have some side effects. But not everyone gets them. Let's break these down into two categories.
| Side effect | Description and what to do |
|---|---|
| Serious side effects that require immediate medical attention | |
| Severe allergies | Skin rash, itching, swelling of the face, lips, tongue or throat. These may be signs of a serious condition. Immediate treatment is needed. |
| Eye pain or vision changes | Sudden eye pain, blurred vision, and seeing colored rings (halos) around lights can be signs of glaucoma. |
| Difficulty urinating | Difficulty urinating or no urination. |
| Increasing difficulty breathing | If you experience difficulty breathing or chest tightness after using the inhaler. |
| Side effects that are usually nothing to worry about, but should be reported to the doctor if they persist | |
| Dry mouth | This is a common occurrence. Try the remedies we discussed earlier. |
| Constipation | Drink plenty of water and eat foods with fiber (fruits, vegetables). |
| Sore throat, stuffy nose | Rinsing your mouth with warm water may provide relief. |
| Stomach discomfort | This can sometimes be reduced by taking the medicine after meals. |
Other medications that may interact with this medicine
If you are taking Tiotropium, it is very important to tell your doctor about all the other medicines you are taking (including vitamins and herbal remedies). Some medicines can interact with it. For example, allergy medicines, cough medicines, some stomach pain medicines, and medicines for Parkinson's disease can affect it. So, tell your doctor about everything you are taking.
Take-Home Message
- Tiotropium (Spiriva) is not a reliever medication. It is a 'controller' inhaler that is used to control symptoms on a daily basis.
- Never swallow the capsule that comes with this. It should be placed in the inhaler and inhaled.
- Take the medicine at the same time every day. If you miss a dose, take it as soon as you remember. But if it is almost time for your next dose, skip the missed dose. Do not take two doses at the same time.
- Tell your doctor about any other medical conditions you have (especially cataracts, kidney and prostate problems) and any other medications you take.
- If you experience increased difficulty breathing, eye pain, or severe allergic symptoms after taking the medicine, seek medical advice immediately.
- Keep the medicine away from children and pets, and store it at room temperature in the original packaging.
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